KIN-NID-62

Code
KIN-NID-62
Mercy ID
V-01769-01
Encounter Date
12/01/2004
Last
King
First
Nidia
DOB
08/31/1962
County
Clayton
Street
950 Lake Ridge Pkwy # 1101
City
Riverdale
State
GA
Zip
30296-
Home
(770) 369-1016
Cell
(404) 454-7908
Family Status
Single adult
COB
Dominican Rep
Gender
Female
Housing
Single Family
Education Level
Grade school

Spouse Information

Last
Castillo
First
Leonardo
DOB
05/25/1962
Address
N/A
Telephone
N/A
COB
Panamá
Home Owner
No
Driver
No
Home Owner
YES
SOLO
No
Court Mandated
No
Program Completed
No
DFCS Mandated
No
Alcohol & Drug
No
Partner Referred to Tepestri
No
Recidivism/Court
No
New Incident
No
Promesa de Confidencialidad
No
Consentimiento De Participar
No

Petitioner

TPO
No
Stay Away Condition
No
Mutual
No

Defendant

TPO
No
Stay Away Condition
No
Mutual
No
Driver
YES
As A Child
No
Relative
No
Stranger
No
As An Adult
No
Partner
No
Relative
YES
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Leonardo King 09/27/1994 Mother GA/USA

Former Spouse 1 Information

Last
King castillo
First
Leonardo
DOB
05/19/1968
Telephone
N/A
COB
Panamá
Home Owner
No
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
G. Landeros
Data Entry
K. Aleman
Referred By
Damaryz